Contraceptive self-efficacy and contraceptive knowledge of Hong Kong Chinese women with unplanned pregnancy

Knowledge, attitude and practice of contraceptive methods among women with an unplanned pregnancy

OBJECTIVES

The study aimed to investigate the knowledge, attitude and practice (KAP) of contraceptive methods among women with an unplanned pregnancy, aiming to improve their reproductive health and increase their understanding of contraceptive methods.

DESIGN

This is a cross-sectional study.

SETTING

The study was conducted at the Maternity and Child Healthcare Hospital of Hubei between 20 November 2022 and 20 January 2023.

PARTICIPANTS

Women with an unplanned pregnancy were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

The questionnaire was in the Chinese language and included demographic data, KAP assessments. Multivariate linear regression was performed to explore the factors associated with knowledge or practice scores.

RESULTS

During the study period, 510 participants with valid questionnaires were included. The KAP scores were 7.30±2.91, 32.61±3.13 and 28.58±3.59, respectively. Place of residence (urban vs non-urban; B=0.66, 95% CI 0.02 to 1.29, p=0.043) and educational level (master's degree or above vs post secondary or below; B=1.07, 95% CI 0.17 to 1.96, p=0.020) were positively associated with knowledge. Knowledge (B=0.25, 95% CI 0.17 to 0.32, p<0.001) and attitude (B=0.26, 95% CI 0.19 to 0.32, p<0.001) were positively associated with practice.

CONCLUSIONS

This study indicates a low level of KAP regarding contraceptive methods among women facing unplanned pregnancies. Place of residence and educational level were positively associated with knowledge scores. These findings may help improve future sex education policies and programmes.

The knowledge levels of midwifery students on contraceptive methods: A cross-sectional study

BACKGROUND

Effective contraceptives used correctly offer many benefits to both women's and children's health. However, public data reports that the rate at which women use an effective contraceptive method is still insufficient. Midwives, including the students, have an essential role in contraceptive counselling so there is a need to determine midwives' knowledge level on contraceptives.

OBJECTIVE

To evaluate midwifery students' knowledge levels of contraceptive methods.

DESIGN

Cross-sectional and descriptive study.

SETTINGS

Online survey.

PARTICIPANTS

290 midwifery students who met the inclusion criteria.

METHODS

The study was conducted between December 2020-March 2021 through Sociodemographic Form and Contraceptive Methods Information Form.

RESULTS

The mean age of the participants was 20.93 ± 1.97. There were 7.72 ± 3.21 correct answers to 15 questions measuring knowledge level of contraceptive methods. The most known modern contraceptive method was the condom, and the most known traditional method was the calendar method. 59.7 % of the participants considered the post-coital contraceptive method as a family planning method. The knowledge level on contraceptives of students who had not received prior training before was lower; and the knowledge level of students who received information about contraceptives through their courses in the curriculum was higher than those who learned from other sources. The level of knowledge increased as age and grade increased.

CONCLUSIONS

Midwifery students had insufficient level of knowledge about contraceptives. Since midwifery students play an active role in family planning, interventions are necessary to deliver more detailed and accurate information about contraceptive methods.

Exploring Readiness for Birth Control in Improving Women Health Status: Factors Influencing the Adoption of Modern Contraceptives Methods for Family Planning Practices

Background: Pakistan is the world’s sixth most populated country, with a population of approximately 208 million people. Despite this, just 25% of legitimate couples say they have used modern contraceptive methods. A large body of literature has indicated that sexual satisfaction is a complex and multifaceted concept, since it involves physical and cultural components. The purpose of this study is to investigate the impact of influencing factors in terms of contraceptive self-efficacy (CSE), contraceptive knowledge, and spousal communication on the adoption of modern contraceptive methods for family planning (FP) under the moderating role of perceived barriers. Methods: Data were collected using an adopted questionnaire issued to married women of reproductive age belonging to the Rawalpindi and Neelum Valley regions in Pakistan. The sample consisted of 250 married women of reproductive age. SPSS was used to analyze the respondents’ feedback. Results: The findings draw public attention towards CSE, contraceptive knowledge, and spousal communication, because these factors can increase the usage of modern methods for FP among couples, leading to a reduction in unwanted pregnancies and associated risks. Regarding the significant moderation effect of perceived barriers, if individuals (women) are highly motivated (CSE) to overcome perceived barriers by convincing their husbands to use contraceptives, the probability to adopt modern contraceptive methods for FP practices is increased. Conclusions: Policymakers should formulate strategies for the involvement of males by designing male-oriented FP program interventions and incorporating male FP workers to reduce communication barriers between couples. Future research should address several other important variables, such as the desire for additional child, myths/misconceptions, fear of side effects, and partner/friend discouragement, which also affect the adoption of modern contraceptive methods for FP practices.

Association of Contraceptive Knowledge, Sexual Double Standard and Contraceptive Self-Efficacy among Unmarried Women in Their 30s and 40s

PURPOSE

To determine association of contraceptive knowledge, sexual double standard, and contraceptive self-efficacy among unmarried women in their 30s and 40s.

METHODS

With a survey design, data were collected from 119 unmarried women in their 30s and 40s in G city of Korea from September 2017 to March 2018. Data were analyzed by descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression.

RESULTS

Contraceptive knowledge, sexual double standard, and contraceptive self-efficacy scores of participants were 8.97±2.22, 18.54±5.57, and 45.84 ± 6.90, respectively. Contraceptive self-efficacy was negatively correlated with sexual double standard. Factors influencing contraceptive self-efficacy were sexual double standard (β =-.26, p=.003), existence of boyfriend (β=.25, p=.004), and contraceptive education need for adults (β=.17, p=.044). They explained 19% of contraceptive self-efficacy of participants.

CONCLUSION

To increase contraceptive self-efficacy of unmarried women in their 30s and 40s, lowering sexual double standard and developing customized contraceptive education according to age and knowledge level are needed. Research on factors related to contraceptive self-efficacy of unmarried women in their 30s and 40s from various regions are also needed in the future.

Effects of Sex Communication with Friends and Sexual Double Standard on Contraceptive Self-efficacy among University Students

PURPOSE

To determine the effect of sex communication with friends and sexual double standard on contraceptive self-efficacy among university students.

METHODS

With a survey design, data were collected from 251 university students from three universities in G city from September 2016 to October 2016. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression.

RESULTS

Sex communication with friends, sexual double standard, and contraceptive self-efficacy scores of participants were 58.82±8.78, 21.73±6.00, and 44.20±5.91, respectively. Sex communication with friends and sexual double standard were related to contraceptive self-efficacy. Sexual double standard, sex communication with friends, female, contraceptive education, and contraceptive experience explained 33% of contraceptive self-efficacy of participants.

CONCLUSION

Sexual double standard and sex communication with friends were influencing factors of contraceptive self-efficacy. To improve contraceptive self-efficacy of university students, a program is needed to eliminate sexual double standard and improve sex communication with friends among university students in Korea.

WOMEN'S EMPOWERMENT AND FAMILY PLANNING: A REVIEW OF THE LITERATURE

This paper reviews the literature examining the relationship between women's empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South Asia (n=24). Household decision-making (n=21) and mobility (n=17) were the most commonly examined domains of women's empowerment. Findings show that the relationship between empowerment and family planning is complex, with mixed positive and null associations. Consistently positive associations between empowerment and family planning outcomes were found for most family planning outcomes but those investigations represented fewer than two-fifths of the analyses. Current use of contraception was the most commonly studied family planning outcome, examined in more than half the analyses, but reviewed articles showed inconsistent findings. This review provides the first critical synthesis of the literature and assesses existing evidence between women's empowerment and family planning use.

The Other Side: How does Informed Choice Affect Induced Abortions among Reproductive-Age Immigrant Women in China-A Cross-Sectional Study

This study attempted to explore how informed choice on contraceptive methods influenced induced abortions among reproductive-age immigrant women in China. A total of 3230 participants were recruited in Beijing, Shanghai, and Chongqing. Information on informed choice was collected by questionnaires. The annual incidence rate (spells) of induced abortions was 0.46 (1500/3230) among the participants. The sequence from the highest score to the lowest was long-term, short-term and natural contraceptive methods (p < 0.0001). Significant differences of rates in induced abortions were found in region, occupation, length of the first immigration up to now (year), purpose for immigration, number of children, marital status, sex preference, contraceptive methods, deciders of contraceptive methods and side effects. In the zero-inflated negative binomial model, the joint impacts showed when a participant with one child employed condoms or family planning service providers as the deciders of contraceptive methods introduced intrauterine devices, the occurrence of induced abortions was more likely to be reduced. Women who underwent side effects using pills were more likely to have had induced abortions.

Reliability and Validity of the Korean Version of the Contraceptive Self-efficacy Scale: Focused on Women University Students

PURPOSE

The purpose of this study was to develop and test the validity and reliability of the Korean version of the Contraceptive Self-efficacy (K-CSE) scale.

METHODS

The K-CSE scale was developed through forward-backward translation methods. Construct and criterion validity and internal consistency reliability were calculated using SPSS/WIN 21.0. Data were collected from 257 women students from two universities in G city, South Korea.

RESULTS

The factor structure of the K-CSE scale showed the cumulative variance as 62.9% in the factor analysis. Factor loading of 13 items on four subscales ranged from .47 to .88. Factors were named as 'initiative of contraceptive use', 'sexual assertiveness', 'refusal of sexual intercourse', and 'autonomic sexual behavior'. Criterion validity compared to the Sexual Autonomy Measurement (SAM) showed significant correlation. Cronbach's α for the reliability of each subscale were .50~.82 and .76 for the total scale.

CONCLUSION

The findings of this study demonstrate that the K-CSE scale is a satisfactory valid and reliable scale. Therefore, the CSE scale can be useful in measuring contraceptive self-efficacy among women university students in Korea.

Barriers to accessing and using contraception in highland Guatemala: the development of a family planning self-efficacy scale

Understanding the persistent inequalities in the prevalence rates of family planning and unmet need for family planning between indigenous and nonindigenous women in Guatemala requires localized explorations of the specific barriers faced by indigenous women. Based on social cognitive theory, elicitation interviews were carried out with a purposive sample of 16 young women, aged 20–24 years, married or in union, from the rural districts of Patzún, Chimaltenango, Guatemala. Content analysis was carried out using the constant-comparison method to identify the major themes. Based on this qualitative study, the following barriers are incorporated into the development of a self-efficacy scale: lack of knowledge about and availability of methods, fear of side effects and infertility, husbands being against family planning (and related fears of marital problems and abandonment), pressure from in-laws and the community, and the belief that using contraception is a sin. This is the first evidence-informed self-efficacy scale developed with young adult, indigenous women that addresses the issue of family planning in Latin America.

Woman's contraceptive needs and preferences in the postpartum period: an Italian study

AIMS AND OBJECTIVES

To describe what puerperal women know about postpartum contraception and to identify their related needs and expectations.

BACKGROUND

Puerperal women face the problem of beginning or resuming contraception, the choice of the right method of contraception and the right time to start it. This choice becomes particularly important in case they breastfeed since the contraceptive method should not interfere with breastfeeding. Different factors, such as the level of knowledge women have about various contraceptive methods, their individual preferences or their desire to have a baby, can strongly influence this choice.

DESIGN

A cross-sectional study had been carried out within the period of six months, from November 2011-February 2012.

METHODS

Three hundred puerperal women were interviewed before their discharge from a Maternity Home. The women were asked for their personal characteristics, their maternity history, the information they had received, their knowledge and expectations about postpartum contraception and their intention to use contraception.

RESULTS

During pregnancy and postpartum, 45.5% of the women reported that they had received adequate information about contraception. Of these ones, 64.3% reported their intention to use contraception either to avoid pregnancy or to space out future births, even if they did not always have appropriate knowledge about fertility and the use of contraceptive methods during postpartum. During this study, we also discovered that women's intention to use contraception was proportional to their level of education.

CONCLUSION

Women need more and appropriate information about postpartum contraception, to make a conscious choice in relation to their needs and without putting their health at risk.

RELEVANCE TO CLINICAL PRACTICE

To promote awareness of the choices related to postpartum contraception, it is important to understand the personal characteristics that influence or hinder this choice. Midwives can play a very important role in informing women and in developing educational interventions to support a safe contraceptive choice.

Development and validation of a reproductive autonomy scale

No validated measures are currently available to assess women's ability to achieve their reproductive intentions, also referred to as "reproductive autonomy." We developed and validated a multidimensional instrument that can measure reproductive autonomy. We generated a pool of 26 items and included them in a survey that was conducted among 1,892 women at 13 family planning and 6 abortion facilities in the United States. Fourteen items were selected through factor analysis and grouped into 3 subscales to form a Reproductive Autonomy Scale: freedom from coercion; communication; and decision-making. Construct validity was demonstrated by a mixed-effects model in which the freedom from coercion subscale and the communication subscale were inversely associated with unprotected sex in the past three months. This new Reproductive Autonomy Scale offers researchers a reliable instrument with which to assess a woman's power to control matters regarding contraceptive use, pregnancy, and childbearing, and to evaluate interventions to increase women's autonomy domestically and globally.

Unintended pregnancy and its correlates among female attendees of sexually transmitted disease clinics in Eastern China

This study is to determine the prevalence of unintended pregnancy and its risk factors among the female attendees of sexually transmitted disease (STD) clinics in Zhejiang Province, China. A self-administered questionnaire survey of a cross-sectional design was administered to attendees at four STD clinics in 2007. Of the 313 female STD clinic attendees, 42.5% reported that they had at least one unintended pregnancy; the induced abortion rate was 39.0%. Over their lifetime, 12.1% responded “use condoms always/often” and 5.4% “always/often used oral contraceptives.” The risk factors for the unintended pregnancy identified by the multivariate analysis were as follows: being married, experience of nonconsensual sex, and a history of STD, having two and over two sexual partners. Unintended pregnancies and induced abortion by female STD clinic attendees have reached an alarming prevalence. Doctors at STD clinics should attach importance not only to the STD problem of the female attendees, but also to the unintended pregnancy and the associated factors. Targeted contraceptive counseling and intervention should be promoted at STD clinics as a strategy to improve the efficiency and effectiveness of the reproductive health services in China.

Knowledge of and attitude to contraception among migrant woman workers in mainland China

AIMS

The aims of this paper were to determine the level of knowledge and attitude of contraception and their relationships among Chinese migrant woman workers.

BACKGROUND

Studies on psychosocial variables that lead to reproductive health behaviours among Chinese migrant woman workers in China remain limited.

DESIGN

A cross-sectional, descriptive and correlational design.

PARTICIPANTS

One hundred and ninety young woman workers of a factory in Guangdong, a representative city of factory base in mainland China, voluntarily participated in the study with a response rate of 63%.

METHODS

Data were collected through self-administered questionnaires consisting of a socio-demographic sheet, the Contraceptive Knowledge Scale and the Contraceptive Attitude Scale. Pearson product moment correlation coefficient test was employed to examine the relationships between the contraceptive knowledge and attitude, with level of significance set at p<0·05.

RESULTS

The Chinese migrant woman workers demonstrated lower contraceptive knowledge and less favourable contraceptive attitude compared with previous studies of adolescents in Taiwan and women seeking abortion in Hong Kong. Although it was a weak correlation, contraceptive knowledge was statistically associated with contraceptive attitudes among the respondents (r=0·276, p<0·001). Respondents' age, education level and working experience were significantly positively correlated with the contraceptive knowledge.

CONCLUSIONS

Young Chinese migrant workers reported in the current study are found to be at higher sexual risk, when compared to the adolescents in Taiwan and Hong Kong women seeking abortion. Early educational intervention for reproductive health in particular contraception and its usage to these young women is indicated.

RELEVANCE TO CLINICAL PRACTICE

Migrant woman workers in mainland demonstrated poor knowledge and unfavourable attitudes towards contraception, especially for the younger, single and less educated group. Greater effort is necessary to promote young migrant women's knowledge and attitude towards contraception and sexual health.